Healthcare Provider Details

I. General information

NPI: 1194766535
Provider Name (Legal Business Name): SARA FOWLER CAWOOD M.S., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4032 SUTHERLAND AVE
KNOXVILLE TN
37919-5186
US

IV. Provider business mailing address

4032 SUTHERLAND AVE
KNOXVILLE TN
37919-5186
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-4435
  • Fax:
Mailing address:
  • Phone: 865-584-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0000000034
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: